title: Who pays for the health benefits of exclusive breastfeeding? An analysis of maternal time costs.
abstract: BACKGROUND
  The benefits of exclusive breastfeeding, including public health cost savings, are widely recognized, but breastfeeding requires maternal time investments.
  
  
  OBJECTIVE
  This study investigates the time taken to exclusively breastfeed at 6 months compared with not exclusively breastfeeding.
  
  
  METHODS
  Time use data were examined from an Australian survey of new mothers conducted during 2005-2006. Data from 139 mothers with infants age 6 months were analyzed using chi-square tests of independence to examine socioeconomic and demographic characteristics and 2-sided t tests to compare average weekly hours spent on milk feeding, feeding solids, preparing feeds, and the total of these. The comparison was of exclusively breastfeeding mothers with other mothers. We also compared exclusively breastfeeding with partially breastfeeding and formula feeding mothers using a 1-way between-groups analysis of variance (ANOVA).
  
  
  RESULTS
  The exclusively breastfeeding (vs other) mothers spent 7 hours extra weekly on milk feeding their infants but 2 hours less feeding solids. These differences were statistically significant. ANOVA revealed significant differences between exclusively breastfeeding mothers, breastfeeding mothers who had introduced solids, and mothers who fed any formula, in time spent feeding milk, and solids, and preparing feeds.
  
  
  CONCLUSIONS
  Exclusive breastfeeding is time intensive, which is economically costly to women. This may contribute to premature weaning for women who are time-stressed, lack household help from family, or cannot afford paid help. Gaining public health benefits of exclusive breastfeeding requires strategies to share maternal lactation costs more widely, such as additional help with housework or caring for children, enhanced leave, and workplace lactation breaks and suitable child care.
authors.affiliation: 1Australian Centre for Economic Research on Health, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia.
authors.forename: J P
authors.initials: JP
authors.lastname: Smith
authors.forename: Robert
authors.initials: R
authors.lastname: Forrester
mesh_terms: D001315:Australia; D001942:Breast Feeding / Q000191:economics*; D003365:Costs and Cost Analysis; D006801:Humans; D007223:Infant; D007225:Infant Food; D041943:Infant Formula / Q000191:economics; D007231:Infant, Newborn; D009035:Mothers; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: breastfeeding; breastfeeding/economics; costs and cost analysis; evolution; gender equity; maternal employment; time factors